Longitudinal Changes of Cardiorespiratory Fitness Performance in High School: Association with Individual and School-Based Variables

This study aimed to model adolescents’ cardiorespiratory fitness performance change trajectories longitudinally across high school years and its relation to school- and individual/student-level factors. We employed hierarchical linear modeling to examine longitudinal cardiorespiratory fitness performance changes, as measured by the progressive aerobic capacity endurance run (PACER), over the years, between sexes, and in association with the school-level variables. Participants were 76,227 adolescents from 80 high schools in the mid-Atlantic region of the United States. School-level academic performance (SAP), the percent of students eligible for free and reduced-price meals (FARM), and physical education student-faculty ratio were obtained with permission from the school districts. The number of laps completed in PACER test improved throughout the first three years of high school, however, proportions of those within the healthy fitness zone (HFZ) decreased overall from 9th to 11th grade. Furthermore, the number of laps completed by adolescents appeared to have plateaued at 11th grade, with a significant decline during the final year of high school. Sex-based discrepancies in performance in meeting HFZ were evident, where girls significantly outperformed boys during 9th and 10th grades, and boys significantly outperformed girls during 12th grade. Additionally, SAP and FARM were positively and negatively, respectively, significantly associated with PACER performance at the school level. The odds ratio of adolescents performing in the HFZ declined significantly over the years, even though the number of PACER laps improved in the first three years. Concerted efforts should be targeted at improving cardiorespiratory fitness in high school due to its positive relationship to academic achievement in schools, and negative association with cardiovascular disease, metabolic syndrome, obesity, and all-cause mortality in adulthood.